Temkin Health
(925) 866-3900
Contact Us
(925) 866-3900

What Is Testosterone Replacement Therapy (TRT) for Men, and What Are the Benefits?

What Is Testosterone Replacement Therapy (TRT) for Men, and What Are the Benefits?

What Is Testosterone Replacement Therapy (TRT) for Men, and What Are the Benefits?

Testosterone replacement therapy (TRT) is the prescription treatment for confirmed low testosterone in men. It restores testosterone to a normal, healthy range in men who have both the symptoms of deficiency and low levels on lab work. The documented benefits are substantial: more muscle and less fat, improved libido and sexual function, better energy and mood, and support for bone density — with the strongest effects in exactly the men TRT is prescribed for, those whose levels are genuinely low.

Are Men Actually Satisfied With TRT?

Yes, and the data backs it up. A 2024 survey of 140 men on testosterone therapy, published in the International Journal of Impotence Research, found that 62.7% were satisfied with their regimen overall — and that men on subcutaneous pellets reported 90.0% satisfaction, the highest figure of any delivery method and significantly above the group average. A separate 2025 UK survey of TRT patients found that 85% rated their treatment effective or very effective, with measurable gains in work performance, mood and self-esteem.

The same UK survey found something else worth knowing: many men wait a year or more before seeking care. The symptoms are easy to write off as ordinary aging, and a lot of men spend a long time feeling flat before they find out there was a treatable reason for it.

Who Is a Candidate for TRT?

A candidate for TRT is a man with symptoms of low testosterone whose levels are confirmed low on two separate early-morning, fasting blood draws. The symptom pattern that most reliably points to a genuine deficiency includes:

  •   Loss of muscle mass and strength despite training
  •   Low libido or erectile difficulty
  •   Increased belly fat that is hard to shift
  •   Fatigue that a good night’s sleep does not fix
  •   Flat, low or irritable mood
  •   Reduced motivation, drive or sense of sharpness

Low testosterone is notably more common in men who also carry excess weight or who have diabetes, high blood pressure or high cholesterol — which is why a proper testosterone evaluation is a metabolic evaluation too, and why it belongs in an internal medicine practice. If any of the list above sounds familiar, a morning lab draw is a straightforward way to find out whether testosterone is the cause. That is the whole first step: two blood tests and a conversation. See also Can Hormone Imbalance Stop You From Losing Weight?.

What Are the Benefits of TRT?

In men with confirmed low testosterone, the documented benefits are these:

Benefit

What the Data Show

Libido and sexual function

The most consistently proven benefit of testosterone therapy in men with confirmed low levels.

Body composition

About 1.6 kg less fat and 1.6 kg more muscle on average, across pooled studies.

Bone density

Consistent increases in bone mineral density.

Energy and mood

Commonly reported by men on treatment, and a frequent reason they say they would not go back.

Anemia correction

Improves unexplained anemia when it is linked to low testosterone.

 

These effects are most pronounced in men whose starting levels are genuinely low, and body composition changes work alongside training and nutrition rather than replacing them. Treatment makes the effort pay off the way it used to, which is often what men notice first.

How Is Testosterone Delivered?

Dr. Temkin is a Certified BioTE Provider, and pellets are the delivery method this practice uses most often. A pellet about the size of a grain of rice is placed under the skin in a few-minute office visit, and it releases testosterone steadily into the bloodstream for roughly three to four months. That means the steadiest levels of any method, no daily or weekly routine to keep up with, and three or four appointments a year instead of an ongoing task. It is also the method with the highest reported patient satisfaction.

The alternatives are injections and topical gels. Injections into muscle every one to two weeks, or under the skin weekly are effective and allow a dose to be changed quickly. Gels are applied daily to the skin and keep levels steady with consistent use. Both are reasonable choices, and Dr. Temkin prescribes them when they suit a patient better. For most men who want steady levels without thinking about it, pellets are the better long-term fit.

Is TRT Safe for the Heart?

This is the question that shadowed testosterone therapy for years, and it now has a clear answer. TRAVERSE, the largest cardiovascular safety trial of testosterone therapy ever conducted, followed 5,246 men aged 45 to 80 who had confirmed low testosterone plus existing heart disease or high cardiovascular risk — deliberately the highest-risk group that could be studied. Testosterone did not increase major cardiac events. A first major event occurred in 7.0% of men on testosterone versus 7.3% on placebo. For a treatment that had spent a decade under a cloud of suspicion, that is about as reassuring a result as a trial can produce.

The same trial recorded modestly higher rates of three things in the testosterone group — irregular heartbeat, blood clots and fractures. All three were uncommon, and all three are exactly what routine follow-up is designed to pick up early: blood count, PSA where age-appropriate, and a check on symptoms at each visit. It is the practical case for managing testosterone therapy with a physician who knows your history, rather than through an online subscription service that ships a vial and checks in by email.

What Monitoring Does TRT Require?

Scheduled lab follow-up, for as long as you are on treatment — and it is one of the more useful parts of the process. Baseline testing covers confirmed testosterone, blood count, PSA where age-appropriate, cholesterol and a metabolic panel, which means you get a fuller picture of your health at the outset than most men have had in years. After starting treatment or changing a dose, levels are rechecked to confirm you have landed in the target range.

Three findings typically prompt an adjustment: a rising blood count, which means the dose is running high; a testosterone level above the normal range, which means dialing back rather than celebrating; and symptoms that have not improved despite good levels, which tells your physician to look further — a genuinely useful finding rather than a failure.

About Dr. Michael Temkin, DO

Dr. Michael Temkin, DO is an internal medicine physician who has been in private practice in San Ramon for 25 years, and he is a Certified BioTE Provider. He manages testosterone therapy personally from start to finish: your initial evaluation and history, the baseline labs and their interpretation, the choice of delivery method, pellet insertions, every dose adjustment and the ongoing monitoring — the same physician throughout, rather than a rotating set of names on a portal.

Temkin Health is a concierge practice, which means unhurried appointments and the ability to reach him directly with questions between visits. It also means your testosterone is looked at in context: because low testosterone travels with metabolic issues so often, TRT sits alongside the practice’s concierge primary care, its LeanMD medical weight loss program and its longevity medicine services. If your labs point to more than one thing going on, it gets handled in one place by one physician.

 

Frequently Asked Questions

What is testosterone replacement therapy?

TRT is the prescription treatment for confirmed low testosterone in men. It restores levels to a normal range using pellets, injections or gel, in men who have both symptoms of deficiency and low testosterone confirmed on repeat early-morning, fasting blood tests.

Who is a candidate for TRT?

A man with symptoms of low testosterone — low libido, erectile difficulty, loss of muscle and strength, increased belly fat, fatigue that sleep does not fix, or flat mood — together with low levels confirmed on two separate early-morning, fasting blood draws.

What are the benefits of TRT for men?

The best-supported benefits are improved libido and sexual function and better body composition — about 1.6 kg less fat and 1.6 kg more muscle on average across studies. Bone density and unexplained anemia often improve as well, and better energy and mood are commonly reported. Results vary between individuals.

What testosterone level counts as low?

The American Urological Association uses 300 ng/dL; the Endocrine Society suggests 264 ng/dL. Both require a fasting, early-morning sample, since testosterone follows a daily rhythm, and both require a low result to be confirmed on a second test before a diagnosis is made. Dr. Temkin reviews your specific numbers with you at your consultation.

Is TRT safe for the heart?

The TRAVERSE trial — 5,246 men aged 45 to 80 with existing heart disease or high risk — found testosterone was no worse than placebo for major heart events (7.0% versus 7.3%). The trial also recorded modestly higher rates of irregular heartbeat, blood clots and fractures, which is why scheduled lab and symptom monitoring is a standard part of physician-managed TRT. Whether it is right for you is decided at a medical consultation.

How long does it take for TRT to work?

Different effects arrive on different timelines. Libido and mood changes are often noticed within three to six weeks. Body composition changes build over months and can keep improving for a year or more. TRT is judged over months rather than weeks, alongside repeat lab work.

Are men happy with TRT once they start?

Very. A 2024 survey found men on pellets reported 90% satisfaction, the highest of any delivery method, and a 2025 UK survey found 85% of TRT patients rated their treatment effective or very effective, with gains in work performance, mood and self-esteem.

Do you have to stay on TRT for life?

Not necessarily. Many men stay on it long term simply because they want to keep the benefits, and stopping generally returns testosterone to its untreated level. Whether to continue is reviewed periodically with your physician, based on how you feel and what your labs show.

Talk to Dr. Temkin About Testosterone Therapy

If you have symptoms that look like low testosterone, the first step is a properly drawn morning lab test and a conversation about your history. Call Temkin Health at (925) 866-3900 or request a consultation online.

About Temkin Health

Temkin Health is a concierge internal medicine practice at 1081 Market Place, Suite 300, San Ramon, CA 94583, led by Dr. Michael Temkin, DO, who has been in private practice in San Ramon for 25 years. The practice offers concierge primary care, the LeanMD medical weight loss program, bioidentical hormone replacement therapy for men and women, and longevity medicine. Dr. Temkin is a Certified BioTE Provider. Phone: (925) 866-3900.

Related Reading

Each of the above is part of Temkin Health’s San Ramon hormone therapy resource library.

Sources

Disclaimer

This article provides general health information and is not medical advice for any specific situation. Reading it does not create a doctor-patient relationship. Hormone therapy is a prescription treatment with risks as well as benefits, and suitability is determined at a medical consultation with a licensed clinician. Results vary between individuals; every figure cited describes findings in studied populations rather than a predicted individual outcome. Compounded preparations, including compounded pellets, are not FDA-approved, which means the FDA does not evaluate them for safety, effectiveness or quality. Consult a licensed healthcare provider to discuss all treatment options, including potential risks and benefits.

Last updated September 2026.

Scroll to Top